*for some definitions of "evidence."
Swift reader Jeff (Yes, there is more than one of us) sent this article from the American Journal of Infectious Disease along in response to my Big Homeopathy piece from a few days ago. Take a look at the report, which is downloadable as a PDF.
I am not an epidemioligist, histologist, or a scientist of any type. I'm just a lay person with an interest in science, and at a glance, that article looks like science to me. It's in a professional science journal, on a site that warehouses scientific content, and it's in a format that matches my vague understanding of how scientific papers are presented.
And, in that brief glance, I can see their conclusion: "Ultradiluted belladonna could inhibit JE virus infection." In other words, this study backs up the claim that homeopathy works.
Now hold up, hula dancers. As a lay person, it's very easy for me to accept the fact that I don't have the training or knowledge necessary to interpret such a document. However, I am allowed to have questions, and reading over the article has raised many.
Here are several of them:
Apparently, the virus that causes Japanese Encephalitis will also infect chicken eggs. This doesn't surprise me as vaccines are made in a similar way. But it is important to note that this study was not done on human subjects, but rather on a vascular membrane of chicken embryos. I'm pretty sure that if I injected pure alcohol into a chicken embryo, it would kill MANY viruses, as well as the chicken embryo. I'm also pretty sure that injecting enough alcohol into a human bloodstream would be enough to kill the human. So even if they claim to have discovered something that kills the JE virus in chicken eggs, that doesn't translate into a useful medicine for us.
However, we're talking about homeopathy here, specifically belladonna. Belladonna, also known as "Deadly Nightshade" looks very much like a tiny tomato, but contains poisonous alkyloids such as atropine. As its name suggests, the plant is extremely toxic. Apparently the symptoms of belladonna poisoining resemble the effects of Japanese Encephalitis, and that's why it was chosen in homeopathy to treat that illness.
Take a look at the concentrations used. According to the study, they used dillutions of 3C, 6C, 30C, and 200C, or 106, 1012, 1060 and 10400. That's not a typo... in the strongest, that is the most concentrated dosage, there was one part of belladonna extract per every 1,000,000 parts of water. I won't fill the page typing the other concentrations, and it doesn't matter, because there was no belladonna in any of them. But that's fine for the homeopath, because the water retains the "memory" of the substance. In fact, the more dillute the substance the more powerful it is.
Ok, fine. So without looking at the results, we can imagine what a positive result would look like: The 3C dosage would have some effect greater than the control, the 6C dosage would have more of an effect, the 30C would have an even stronger effect, and the 200C would have the strongest effect of all. And yet, that's not what we see.
The "t" value is what we want. For the first two, there is an effect, and the "P" value suggests it's a strong one. But then in the 30C trial we see less of an effect than the 6C trial, and the 200C trial has an even lower effect. So, if there was an effect, how can it be attributed to homeopathic priniciples when the results don't match what homeopathic principles would predict?
There are a few other anomalies. Why does the "N" or number of trial subjects change? And why do the pock counts on the controls vary so much? And where is the data on the "Eggs that were dead or yielded deformed or absent CAM" which is mentioned at the bottom?
Now, look at this study this way: injecting the same substance into eggs should produce the same results time and time again if every other variable is controlled for. As none of these preparations had any belladonna in them, what could explain the different results? I can only hypothesize, but my guess is that the experiment was poorly controlled and that there were many unaccounted for variables affecting the results.
Another interesting note: I can't find any reference to this being a double-blinded study. If it wasn't, that opens the door to many forms of bias, and the resutls are automatically suspect.
But, as I said, I'm a layman – I may have gotten all this wrong. This institution, the School of Tropical Medicine in Calcutta, part of a school that has programs in homeopathy and ayurveda, may be on to something, and perhaps this will shake up what we know about science and the world around us. But something has to happen first: the study has to be replicated. And somehow, I suspect that's not going to happen.
If a homeopath points to this study and says "See? Homeopathy works!" they're going to be challenged on several points:
1) Why didn't the more dillute substances produce a better result?
2) What mechanism explains what happened?
3) Where are the replicated studies?
and 4) What happens when this treatment, which should be harmless according to both homeopathic and scientific principles (not the distinction), is applied to human subjects?
I'll say it a third time: I'm a layman. I'll happily accept correction if I missed something or misinterpreted something. My point is that just because it quacks like a duck (It was found in a legitimate scientific journal) and it looks like a duck (it resembles scientific papers) doesn't mean that it is a duck (real science). Duck or not, my lay opinion is that this study is quack medicine.
For the last two years, I have had the great pleasure of being part of Camp Inquiry. Camp Inquiry is the summer camp put on every July in Holland, New York by the Center For Inquiry. The camp, for children aged seven to sixteen, offers the kind of activities that are found at most summer camps. You’ll see volleyball, water balloons, campfires, sing-alongs, and nature hikes, but there’s much more, and that’s what makes it so special. CI puts a special emphasis on helping children navigate the big questions that we all face: Who am I? Why am I here? What can I know? What ought I to do? This is done with the help of special guests including artists, writers, scientists, and public intellectuals who give lectures and workshops, but also share s’mores around the campfire and get into deep conversations . After just five minutes at CI, it is obvious that this place is unique. This year’s guests included Jennifer Michael Hecht, Dale McGowan, Ben Radford, and of course, James Randi.
The children had great discussions with Dale McGowan, had a poetry workshop with accomplished writer, Jennifer Michael Hecht, and even learned the finer points of monster hunting with leading paranormal investigator Ben Radford. Few would disagree though, that James Randi’s two-day visit was the highlight of the week. Randi spent two tireless days giving talks on his life as an investigator of extraordinary claims covering everything from faith healers to bomb detectors. The campers learned about his life as an important figure in 20th century magic and watched video of his frigid escape over Niagara Falls. While all of this was a treat for the campers and counselors, it was all the little things that will make for the fondest memories and the greatest inspiration. Randi spent hour after hour sitting with kids, telling jokes, performing magic, answering questions, and sharing his amazing stories. I had such fun listening to kids retelling Randi’s stories to their parents as they arrived at Camp. Most of the campers had heard of James Randi before they arrived at CI. It’s safe to say that many really knew him when they left on Friday night. I hope that Randi came away half as inspired as the kids were.
As an educator I always had to be on my toes, not only to prevent undesirable behavior, but also to be aware of something much more elusive. Teachers are always on the lookout for something called a "teachable moment". They are tricky because they don't appear in your lesson plans, you have no idea where they will come from or when, and they may not even be on topic. Even trickier, you usually have a limited amount of time in which to take maximum advantage. Very often, the next thing you say determines whether or not you let that teachable moment slip by.
I was fortunate enough to capture one with my son just the other day. My father-in-law believes in all kinds of woo, and after talking with him my 9 year old son came to me very excited, his head full of stories about reincarnation, past life regression through hypnosis, and the possibility that after I die I'll come back as his child. Well, you can imagine how I felt. I opened my mouth, fully intending to say "Your grandfather has fed you a load of crap", when it hit me: this was a teachable moment. Instead of declaring those concepts bunk and leaving it at that, we had ourselves a dialogue.
Me: If people have lived before, why don't they know it? Son: Grandpa says they can't remember. Me: Well if they can't remember, how does Grandpa know? Son: He heard it somewhere. Me: Where did he hear it from? Son: *shrug* I don't know. Me: Well I do. He heard it on a radio show where they talk about a lot of unusual ideas. {I gave him a sample of topics you might hear on Coast to Coast} Now you have to ask yourself, is that a reliable source? {then followed definitions of "reliable" and "source} Ok, now, would you believe me if I told you there is a species of lizard in Texas that can shoot blood out of its eyes?
Me: If people have lived before, why don't they know it?
Son: Grandpa says they can't remember.
Me: Well if they can't remember, how does Grandpa know?
Son: He heard it somewhere.
Me: Where did he hear it from?
Son: *shrug* I don't know.
Me: Well I do. He heard it on a radio show where they talk about a lot of unusual ideas. {I gave him a sample of topics you might hear on Coast to Coast} Now you have to ask yourself, is that a reliable source? {then followed definitions of "reliable" and "source} Ok, now, would you believe me if I told you there is a species of lizard in Texas that can shoot blood out of its eyes?
I must admit to a bit of fortuitous chicanery here. I didn't know of the existence of such a creature myself until just the night before, when I happened to see a Smithsonian program on TV. I knew my son wouldn't believe a word of it, which is what I was counting on. After all, the lesson was in critical thinking, not that fantastical things aren't true. We did an online search, selected a website, and read about the Texas horned lizard. (It eats a particular type of ant which contains a toxin that the lizard absorbs into its blood, making it very distasteful to predators. By squirting out a sample as an appetizer, the lizard can avoid becoming the main course. Gross, but effective.) Before letting him walk away with the information, I asked him if this was a reliable source. What website was it? Animal Planet. Do they know what they're talking about? Most likely. To seal the deal we went on YouTube and found some footage of the critter in action. When he left to go talk excitedly to my wife, it was not about reincarnation but about blood-spitting reptiles.
I'm aware there are some flaws in my approach. I would have done things much differently and more thoroughly if I were speaking with a teenager or adult instead of a 9 year old child. But considering my audience and the fact that I'm very knowledgeable about his temperament and attention span, you'll have to trust that I handled it as best I could.
So there you have it. A mild debunking, an exercise in critical thinking, and some zoology thrown in for good measure, completely off the cuff. And it all started with the mention of some topics I'd generally rather not have mentioned. Keep an eye out for those teachable moments. They can be quite valuable.
The 'net has been abuzz with reviews and comments about The Amaz!ng Meeting 8. Here's a round up of some interesting ones we've run across. This is by no means an exaustive list, but there's something of interest for everyone here.
Geo-Geek Rachael gives a nice, one-page summary of TAM 8 on her blog, 4.5 Billion Years of Wonder.
Hemant Mehta live-blogged all of TAM. If you'd like to experience TAM as though you were there, or relive the event through the words of Hemant, I recommend you check out his efforts on The Friendly Atheist.
Dylan Keeburg of Woo Fighters gives an indepth daily review of TAM starting with some of the Thursday workshops.
Skeptreview's Karl also gave an indepth daily report, but with the added benefit of being Michael Goudeau's shadow. If you're a fan of Penn Jillette or Michael Goudeau, you'll want to read this one.
Daniel Loxton of Skeptic Blog expanded on some of the ideas presented at TAM with his thoughtful piece on The Reasonableness of Weird Things.
CSI's Joe Nickell discusses TAM 8, and also his "out of body" experience meeting Lance Burton for the first time.
Also writing for CSI, Karen Stollznow, points out the lasting effect of Amaz!ng Meetings, and how each of us carried home a little piece of the event to share with others.
The JREF thanks all these reviewers for taking the time to share their thoughts. For more reviews and comments, you can check out the Twitter hash tag #TAM8.
Rick Lax of Las Vegas Weekly attended TAM and was surprised to find what we've known all along – Skeptics aren't the nay-saying curmudgeons that they're made out to be. In fact, he had quite a nice time and has many interesting things to say about his experiences.
He examines in some depth the question asked by a moon hoax afficianado of Adam Savage, and discusses the honesty of skeptics with Richard Dawkins. And he learned the history of the skeptics movment in a hot tub.
Read all this and more, at Las Vegas Weekly.
"Homeopathy is safe and has no side effects, yet 'Big Pharama' keeps pushing their poisons on us because they're greedy."
Have you heard this before? I have. If modern medicines have side-effects or aren't effective in 100% of cases, the reason doctors don't stop using them is because so-called 'Big Pharma' makes tons of money off of them.
Well, part of that is true. Pharmaceutical companies do make money from the products they make. Just like McDonalds or Home Depot or.... hey, what's this? Companies that make homeopathic products make money too!
Let's consider just one: Boiron.
Boiron makes homeopathic "remedies." They are a corporation, in fact they're the second largest maker of over the counter preparations in France. Here's their page on their 2009 end-of-year market capitalization. Looks like business to me, and yes, looks like a BIG business. They make the common preparation Oscillococcinum, which is a homeopathic preparation of muscovy duck liver supposed to treat influenza. In other words, they're sugar pills that are sold for about $2.50 a pill. During the recent H1N1 outbreak, I noticed that the large display of the product was almost empty in a local "health" food store.
$2.50 a pill isn't unheard of in prescpription medicine, but when you consider that homeopathic remedies require no FDA regulation, no testing, no trials, and apparently very little quality control, their profit margins must be considerable.
All arguments about the "greed of Big Pharma" can be thrown right back at the person making them. There is greed in the pharmaceutical industry and no one is disputing that, but the industry is heavily regulated, and most important of all – they have proven results.
Homeopathy is amost pure greed. Other than the occassional placebo effect, we know it doesn't work, and so must the makers.
Like millions of Americans, I went to the local movie theater last weekend and watched the world bend in the Leonardo DiCapprio movie Inception. And while the movie didn't leave me with much to talk about, the pre-show Powerpoint presentation did. Mixed in amongst the ads for local eateries and trivia questions, was an announcement for a clincial study of an experimental vaccine against the virus that causes Dengue Fever, a disease which affects tens of millions of people each year.
The people developing this vaccine could be responsible for saving a very large number of lives, and I'd just been invited to help out. I snapped a picture of the slide with my iPhone and gave them a call after the movie.
As it happens, this was not the first time I expressed interest in a study. In the early 1990's while I was a student at the University of Utah, I was a subject in a phase III trial of the drug lansoprazole. You may know this medicine as "Prevacid," which recently became an over-the-counter medication in the US. A "phase III" trial is the last stage of trials before the product hits the market widely. The drug has already been well-tested at this point, but even so, the FDA demands testing on hundreds and thousands of people (at the expense to the drug company) to be as sure as possible of safety. If 1:1000 people have a problem with a drug, that could translate to thousands of problems down the line, so we're all reaping the benefits of this highly scrutinized process.
At orientation I learned that this drug was nearly ready for market, but there were minor concerns over effects on testicle size, seminal volume, and some other things that I don't recall. I had several medical examinations, including EKG's and I was sequestered for a few weekends and required to eat very specific foods so that my metabolites could be compared with the other subjects through carefully timed blood draws. I had 90 in total. And yes, I was asked to provide semen samples and subject myself to testicular calipers a few times. (One odd note... no one was allowed to "help" with semen collection – we were required to "fly solo." Somehow, we all managed.)
We were in a dorm during those sequestered weekends, and we spent the weekend reading, playing pool, and watching movies. Most of the subjects were students like myself. We were being paid $1,000 for our time, and given that we were able to study while sequestered, it was a perfect arrangement for students.
One test subject was not a student. He was, he said, the Messiah, and had come to Earth to redeem the Mormon faith. You may have heard of him – his name was Brian David Mitchell, and 10 years after the study was over, he abducted 14-year old Elizabeth Smart. The story of my interactions with him are for another article.
There was a 50/50 chance that I recevied not the drug but instead a placebo, and I have no way of knowing as it was a double-blind study. I experienced no side effects, and the drug was ruled safe and effective by the FDA.
As I mentioned, this study was costing Abbot, the pharmaceutical company, a great deal of money. Sadly for them, an oversight among the medical staff meant that I did not receive an EKG when I was supposed to, and though I went through the rest of the steps and did get paid in the end, my data and those of a few others were invalidated. I also believe the University of Utah Medical School lost their contract with Abbot over this incident.
I tell this rambling story to encourage people to consider joining a drug trial. There is risk – these are, by definition, drugs and treatments that are unproven. You will be compensated, and if you have a chronic illness, you may receive treatment unavailable in any other way. It's not always a pleasant experience, but you will be doing something that could help alleviate the suffering of countless millions of people. If you're a student, retired, or just have a bit of time (or need for some extra cash) visit clinicaltrials.gov to see if one interests you.
Upon calling the University of Vermont, I was informed that I do not qualify for the Dengue Fever study because I have been previously vaccinated against Yellow Fever, a similar viral infection. I had planned to blog about the experience of going though the trial, but now I'm going to ask you to fill in for me.
Though this article is rambling in narrative, I hope it gets across the idea that a great deal of care and effort is put into the develoment of modern drug treatments. My data was excluded because of a simple mistake, though it's unlikely that the data they missed would have had any impact whatsoever. They paid hundreds of young men $1,000 each to test a drug that had already been extensively tested, and this was just one of likely several phase III trials. If a drug hits the market in the US, you can be assured great care has been taken to show that it's safe and effective.
It's not perfect, but no "ancient wisdom" or "proofing" can compete with the rigorous and laborious testing that modern medical science offers and the FDA demands. And you can be a part of making the world a better place by considering becoming a subject in a trial near you.
Unless you are new to the JREF, you know who Phil Plait is. Blogger, skeptic celebrity, and past-president of the JREF, he left the JREF last year to pursue a secret television project, even as he remains connected to our efforts, having recently spoken at TAM8 and serving on our advisory committee. Everyone at the JREF is very excited to announce that his new TV show is appearing soon on the Discovery Channel. Called Bad Universe, his new program will promote skepticism about pseudoscience and offer scientific explanations of the mysteries of the universe, in addition to giving Phil's popular take on topics in astronomy. The trailer looks amazing! From all of us at the James Randi Educational Foundation -- Congratulations, Phil -- it is high time that your work gains an even wider audience.
We are here to add to the sum of human goodness. To prove the thing exists. And however finite each individual act of courage or generosity, self-sacrifice or grace – it still proves the thing exists. Each act adds to the fund. It needs replenishment. – Josephine Hart
I have occasionally seen people lament (or brag, depending which side of the aisle they're on) that one of the advantages a faith-based organization has over other types is its ability to raise funds for charities with relative ease. There is no doubt that these groups, from the local soup kitchen to the Salvation Army, do a tremendous amount of good. But that doesn't mean you can count out an outfit like the good ol' JREF. So gather around children, because I have a story to tell.
As I've mentioned here before, I have ALS, or amyotrophic lateral sclerosis. It is better known as Lou Gehrig's disease, a neuromuscular disorder that quickly robs its victim of most voluntary movement while leaving the mental processes intact. Essentially the patient becomes trapped in his own body. Aside from the baseball figure for whom it is named, probably the most famous person to be diagnosed with ALS is Stephen Hawking. Most of the time the limbs are the first to go. Between 10-20% of cases, however, are "prebulbar", meaning the symptoms start in the mouth or throat region. Such was my situation. About 2 1/2 years ago I noticed I'd occasionally slur a word or two here and there. As time went on the effect became more frequent and more pronounced. Soon it was quite noticeable in everything I said. Eventually only those who knew me well could comprehend me, but not for long. At the present time, there are about half a dozen words I can say that only my wife understands.
As my speech deteriorated, my reliance on other forms of communication grew. I started simply by carrying a notepad and pencil. I considered learning sign language but the tremor in my fingers suggested I wouldn't have the use of them long enough to make it worthwhile. I went through a variety of text-to-speech devices, tried TTY, and spent a lot of time chatting online with friends. Last November, I lost the ability to use a mouse and keyboard. For the next six months I went without a computer, and my sole means of communication was tapping out texts on a touch screen cell phone using a chopstick as a stylus.
Lest you think this is a sob story, let me assure you it is not. It is one of hope and goodwill, of kindness and friendship. The time was coming soon when I would no longer have enough movement in my hands to even use my cell phone, but there was an option. I learned through our local chapter of the ALS Association (a wonderful organization; check it out at www.alsphiladelphia.org) of an eye gaze system where cameras track the movement of your eyes and direct the cursor accordingly on an on-screen keyboard. The only problem was that even with insurance, the cost was prohibitive. It would take close to a year to save it up.
Enter the skeptic community. Through the generosity of scholarships and individuals (a story in itself) I was able to attend TAM7 last year, my first one. I shared a room with a very kind man and we exchanged numbers so we could find each other over the course of the weekend. Nine months later he discovered he still had it, dropped me a line, and we corresponded a bit. I mentioned my situation and something I said must have resonated because what happened next was, in my eyes, nothing short of astounding. Unbeknownst to me, he took it upon himself to go on the JREF forum and start a fundraiser, building a website and hosting it on a server out of his own home. As he put it, he threw a snowball at the mountain and the mountain responded with an avalanche. At least two discussion threads were started. Skepchick.org picked up on it and I'm told it got a mention in Bad Science. Soon the site had a few hundred hits, then a couple thousand. And in just four days, the cost of the system had been covered. Two weeks later it arrived, and for the first time in nearly a year I could use a voice to speak to my wife, my children, and my friends.
It was all due to a bunch of people some of whom I've met exactly once, many who I've just exchanged comments with online, and a few who don't know me at all. It was people from JREF, but also some from sites I haven't visited very often. There were people from all over the country who donated, and I suspect a few from beyond our borders as well. So what's the common thread that links these folks together? They are good. They are kind. They are altruistic. And they are members of the skeptic community.
This was not an isolated incident. When Robert Lancaster, creator of such sites as StopKaz and StopSylvia, found himself dependent on a wheelchair, the members of the JREF made sure he would not be homebound by rallying together and getting him a handicap-accessible van. The JREF as an organization provides scholarships and educational opportunities, and last year the generosity of its members provided the funds for vaccinations to over 300 children from underprivileged families in just one weekend. In fact, judging from the speed at which these things come together once people set their mind to it, I'd venture to say that the charitable projects I've witnessed undertaken by the skeptical community are more efficient and effective than any church-sponsored bake sale or 5K run I've seen.
I know what loving and giving people JREF members are. If you didn't before, you do now. So I suppose the only thing left to do is let everyone else know. Take another look at the first sentence I wrote in this article. What those people are observing is not a truism; it is merely a perception, and not one we have to live by. A grassroots movement on the local level can have a tremendous impact. Have your own skeptic's organization set up a scholarship for the home town high school senior who demonstrates exceptional critical thinking skills. Pick a neighborhood family who is down on their luck to be the beneficiary of a 3rd grade read-a-thon. Offer to read aloud during story time at your library or bookstore (and if they don't have a story time, they should, so start one! ). Skeptics as a rule are very intelligent and imaginative. If those qualities were applied to charitable means on a large scale on a regular basis, the possibilities would be endless.
No act of kindness, no matter how small, is ever wasted. – Aesop, The Lion and the Mouse
Michael is known as "NobbyNobs" on the JREF Forum.